Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS J9359 (Zynlonta) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, loncastuximab tesirine-lpyl, 0.075 mg
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office 22 - On Campus Outpatient Hospital |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J9359 |
| Medicare Payment Limit | $216.903  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9359 by major payers:
$205.93
$221.24
$225.30
$218.24
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J9359.
HCPCS J9359
5 of 25 sample ratesHigher to lower in this preview
Joseph Baron
$284.23Published rateHolland Hospital, Holland Hospital - Cfgh
Holland Community Hospital
$236.13Published rateDanny Markabawi
$218.25Published rateJenia Jenab-Wolcott
$206.72Published rateCarole Dubuche
Sun River Health Inc
$105.25Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J9359 vs. Other Chemotherapy Drugs Codes
The HCPCS J9359 code is part of the Chemotherapy Drugs services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J9359 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| J9358-HCPCS | Low | Injection, fam-trastuzumab deruxtecan-nxki, 1 mg |
| J9359-HCPCS | Moderate | Injection, loncastuximab tesirine-lpyl, 0.075 mg |
| J9360-HCPCS | Low | Injection, vinblastine sulfate, 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9359. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9359 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J9359) and we'll show you how you compare in 15 minutes or less.